Doctor Name: | MR. WAYNE HERBERT WOODWARD |
NPI Number: | 1023079340 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 249174 |
Business Practice Address: | 6010 W Amarillo Blvd Amarillo, TX - 791061990 |
Business Phone Number: | 8063559703 |
Business Fax Number: | |
Mailing Address: | 7718 Tripp Ave, AMARILLO |
State: | TX |
Postal Code: | 791211768 |
Phone Number: | 8063530100 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 249174 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |